| NPI | 1144614215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX 1125496) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0008439) |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2025-03-04 |